Microendoscope-Assisted Versus Open Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Multicenter Retrospective Cohort Study

Abstract

Background and objectives: Minimally invasive surgery has become popular for posterior lumbar interbody fusion (PLIF). Microendoscope-assisted PLIF (ME-PLIF) utilizes a microendoscope within a tubular retractor for PLIF procedures; however, there are no published reports that compare Microendoscope-assisted to open PLIF. Here we compare the surgical and clinical outcomes of ME-PLIF with those of open PLIF. Materials and Methods: A total of 155 consecutive patients who underwent single-level PLIF were registered prospectively. Of the 149 patients with a complete set of preoperative data, 72 patients underwent ME-PLIF (ME-group), and 77 underwent open PLIF (open-group). Clinical and radiographic findings collected one year after surgery were compared. Results: Of the 149 patients, 57 patients in ME-group and 58 patients in the open-group were available. The ME-PLIF procedure required a significantly shorter operating time and involved less intraoperative blood loss. Three patients in both groups reported dural tears as intraoperative complications. Three patients in ME-group experienced postoperative complications, compared to two patients in the open-group. The fusion rate in ME-group at one year was lower than that in the open group (p = 0.06). The proportion of patients who were satisfied was significantly higher in the ME-group (p = 0.02). Conclusions: ME-PLIF was associated with equivalent post-surgical outcomes and significantly higher rates of patient satisfaction than the traditional open PLIF procedure. However, the fusion rate after ME-PLIF tended to be lower than that after the traditional open method.

Comparison of Outcomes of Lumbar Interbody Fusion and Full-endoscopic Laminectomy for L5 Radiculopathy Caused by Lumbar Foraminal Stenosis

“…The basic operative procedure has been described previously. 13 - 15 ) In brief, a tubular retractor (METRx: 18 mm, Medtronic Sofamor Danek, Dublin, Ireland) was initially placed at the vertebral lamina overlying the L5/S1 disc. All procedures leading to interbody fusion, including decompression, removal of an intervertebral disc, grafting of autologous bone, and cage insertion, were performed within the tubular retractor.…”

“…We and other investigators previously reported that the operative outcomes were similar to those of conventional LIF. 13 - 18 ) In contrast, uniportal full-endoscopic spine surgery (FESS) was originally developed for the treatment of lumbar disc herniation and has recently been used for spinal canal stenosis. 19 - 21 ) Full-endoscopic laminectomy via the translaminar approach (FEL-TLA) has been developed for the treatment of LFS.…”